Holly House Short Breaks Unit

Holly House Short Breaks Unit

Holly House provides short breaks for children and young people with disabilities from the ages of 8 to 18 who live in Pembrokeshire.

Referrals to the service are made through the Children with Disabilities team, following assessment.

Statement of purpose

About the provider

Service provider: Pembrokeshire County Council

Legal entity: Local authority

Responsible individual: Darren Mutter, Head of Children's Services, Pembrokeshire County Council

Manager of service: Gail Pawlett 

Name of Service: Holly House short break home

Address of service: Holly House, Portfield, Haverfordwest Pembrokeshire SA61 1BS tel: 01437 769858

Description of the location of the service

Holly House is a purpose-built bungalow designed to accommodate the needs of young people with physical and learning disabilities and associated health needs. It is situated in Haverfordwest close to Portfield School – the school that provides education to many of the children who attend Holly House – in a secluded area, a short distance from the main road. On the same site but in separate buildings are day services for adults.

External to the front of the building are several parking spaces with a one-way system linked to the front of Portfield School, ensuring traffic flows in one direction past Holly House. The proximity of the school means that for those children who attend the school and also use Holly House’s services, they are able to finish school and can be escorted directly to Holly House without in most cases, requiring transport. It also means that with the permission of the Headteacher at the school, staff can make use of the some of the outdoor space and the hydrotherapy pool at the school, when pupils are not present (e.g. during school holidays).

Holly House is close to several community facilities such as several local accessible parks, many with paths to walk or ride bikes/scooters on; several large supermarkets; other local primary and secondary schools; Haverfordwest leisure centre; the town cinema; tennis courts; as well as the local town centre with the facilities that it provides such as cafes, shopping areas and a newly built library. Haverfordwest also has a youth centre located at The Hive in Goshawk Road 1 mile away.

Haverfordwest is roughly central within Pembrokeshire meaning it is equally accessible in terms of travel time from most areas of the county. Whilst Holly House is close to a number of GP and dental surgeries, young people remain registered with their own GPs/dentists, and parents/carers provide written consent for them to be treated at a local surgery in the case of an emergency. Holly House is also only approximately 1 mile away from Withybush General Hospital. As Withybush hospital does not provide paediatric care overnight, the next closest hospital that does so, in the event a child staying at Holly House requires hospital treatment or emergency intervention, is West Wales general Hospital in Carmarthen, which is 32 miles away.

Holly House is close to public transport links with the train station located in the town and a bus station also being close by with stops in various places in the area surrounding Holly House. Haverfordwest is only a short drive away from several local beaches and several of Pembrokeshire’s sites of interest. Broadhaven Beach for example is 6 miles away and St David’s is 15 miles away.

The facility is also close the main council offices where the Children With Disabilities Team within Children’s Social Care is based.

About the service provided

Range of needs we can support

Holly House provides respite services, support and care to children and young people with a wide range of disabilities and support needs who live in Pembrokeshire. This includes children and young people with a range of learning and physical disabilities, children and young people who have a mild learning disability who require minimal support, and children and young people who have profound and multiple learning disabilities who require a high level of support. Each young person will have a care and support plan to show what their support needs are and how their needs will be met to ensure support is provided at the right time, the right place, the right pace and level required.

Referral for respite and ongoing assessment of need will be outcomes-focused, with Holly House clearly being identified as the best way of meeting specific needs. The child or young person’s plan will show how specific activity at Holly House will achieve specific identified outcomes, such as independence skills, family support or development of a specific hobby or interest. Assistive technology may be used to support some individuals to gain independence. Holly House also has provision to care for children with specific health needs associated with their learning and physical disabilities, and where required specific training can be provided to staff, usually via health colleagues, in the provision of safe overnight care to young people requiring regular medication.

Age range of people using the service

8-18 years old

Accommodation based services

Maximum Capacity: Four children for overnight stays

How the service is provided

Arrangements for admitting, assessing, planning and reviewing people’s care.

Assessment and Admission procedure

Prior to consideration of a child/young person receiving Holly House’s services, an assessment will be carried out by a member of the ‘Children With Disabilities Team’ in the Children’s Services Department of Pembrokeshire County Council. If the assessment recommends that a child’s needs might be partly met by the provision of Holly House respite services, then a referral is made via the Carefirst system, and considered at the Matching Needs to Resources Panel, attended by the manager of Holly House along with the manager of the Children With Disabilities operational team.

The referral (a ‘Matching Needs to Resource’ form) will need to make clear what the needs of the child/young person are, how they are ordinarily met, along with the outcomes that attendance at Holly House will achieve. There must be a clear link between the assessed need and how attendance at Holly House will meet that need. This referral will be read and considered in conjunction with the originating assessment and any relevant risk assessments, by the Holly House manager. The allocation of a place in Holly House must be to meet an identified need or needs, where the outcome can be measured and evidenced, to ensure over time that the provision remains appropriate and proportionate.

Home Visit

Once the MNTRP has approved the request for a place at Holly House, the Home Manager or Senior Carer will arrange a home visit with the referred young person, along with a parent or carer, and the allocated and referring social worker, at their home prior to admission. This provides the opportunity for sharing of information and planning the young person’s stay at Holly House. The Home Manager will then be able to answer any questions that the young person and their family/carer may have and the person can give a view of their expectations and wishes.

Introductions

Arrangements will be made to introduce the young person to Holly House – this can be a gradual process and can be over a period of time leading up to an overnight stay to ensure the young person is happy and has time at their own pace to become familiar with Holly House. The focus will be on ensuring that the child becomes familiar with their surroundings and the routines in order that the respite does not cause any upset. Introductions will move at a pace as dictated by the child. The whole staff group who will have care for any young person, will be briefed on any new young person attending for respite, so as to ensure a joined-up and informed approach to their care. Additionally, any changes to a young person’s plan and how their needs will be met at Holly House, will be communicated to all staff, again to ensure the continued and appropriate meeting of need

Care and Support Plan

A Care and Support plan will be put together with the young person and their family/carer prior to the respite being implemented. The plan will contain meaningful information about the young person based on a person-centred and easy-read tool covering:

• information about the young person
• what the young person will do at Holly House
• what help and support the person will need
• what the outcomes are that it is planned the person will get out of staying at Holly House.

Review of Care and Support Plan

In order to ensure that the provision of respite continues to meet an identified need, the provision of the service will need to be considered regularly. The review of the service will consider whether changes need to be made to the respite plan and the support provided, particularly if it is identified that it is not meeting an identified need. The review will be arranged and co-ordinated by the social worker from the Children With Disabilities team, and will be attended by the manager from Holly House, or where they are not able to attend, a suitable replacement from within Holly House staff.

Emergency Placements

Holly House does not provide emergency provision.

Standard of care and support

The approach of Holly House staff is based on the idea that at all times, children, young people and their families will be treated with respect. Specifically, this will be demonstrated through the following:

• treating all young people with dignity, embodying the principles of inclusion and equality, and maintaining confidentiality at all times.
• providing care and support to people based on a person-centred approach as identified in the child/young person’s ‘Multi Agency Care and Support Plan’. This will vary for each young person and will speak specifically to their particular assessed needs.
• supporting and assisting young people with their personal care support needs where required, and doing so with care, patience and whilst maintaining dignity.
• encouraging individuals to be as independent as possible through active participation with daily household tasks, and by paying focused attention to those areas that they need to develop as identified in their assessment of need.
• enabling young people to have a say in what activities they would like to do, focusing on overall health and well–being, life and independent living skills and inclusion in all aspects of their stay at Holly House.
• assisting young people to access the local community, visiting shops, clubs, activities and community groups.
• Helping to meet, children/young people’s spiritual needs during their stay by supporting them to access worship in the most suitable way.
• guaranteeing privacy whilst in their bedrooms, while using the telephone and while communicating with relatives, friends and professionals. Where appropriate, alternative private space will be made available for such discussions.

Language and communication needs for people using the service

Holly House demonstrates its values in respect of its approach to communication by recognising and demonstrating the following:

• People communicate in lots of different ways: this includes verbal and non-verbal communication.
• The use of easy ready information in the form of symbols, pictures and photographs will be the best way to communicate with some young people.
• The use of Key Word Signing (with speech) will be used where required, to help young people understand and communicate.
• Staff understand how to support someone using their communication book / tablet and other Visual Supports e.g. easy read menus, timetables, staff rotas.
• Young people will know which staff are present on arrival due to the pictures of staff being posted in the reception area of Holly House.
• Young people will be able to identify their own and each other’s rooms as they will have their photograph fixed to the outside of their allocated room (with parental agreement)
• To ensure essential supports are constantly in use and not stored away.
• To respond to people who use Objects of Reference to communicate.
• Use Body Signing (if recommended).
• Importance of an Intensive Interaction approach (if appropriate).
• To follow any individual Speech and Language Therapy Plan as highlighted in the Care Plan
• Pembrokeshire County Council has ‘Communication Standards, Services and Resources’ Policy dated November 2020, that sets out the authority’s approach to the use of Welsh and is linked to its own action plan for implementation of Welsh Government’s ‘More Than Just Words (opens in a new tab) ’ Framework. Pembrokeshire County Council adheres to the Welsh Language Standard Regulations 2016. 

All written signs within the home are bi-lingual and this applies also to the signs with pictures that have words underneath. The reception areas that the public have access to, has a sign to say Welsh can be offered though prior to any involvement with Holly House, families and young people will have been pro-actively asked about their preferred methods of and language for communication – in both written and verbal form.

Staffing requirements

Numbers and qualifications of staff

• x1 Registered Responsible Individual: MSc Management; MSc Applied Social Studies; Diploma in Social Work
• x1 Home Manager: Level 5 Diploma / NVQ 4 Management
• x1 Deputy Home Manager: NVQ 3, Level 5 Diploma maintains all mandatory training
• x2 Senior Support Worker: NVQ 3 Caring for Children and Young People and maintains all mandatory training + 1 member of staff working towards their NVQ3 (who already has a degree in social studies with an add on in additional needs) 
• x5 Support Worker: NVQ 3 Caring for Children and Young People and maintains all mandatory training.  3 having relevant NVQ 3 training. The remaining 2 staff are both on probation and, if successful, will be put onto the relevant training.

NB – all staff are required to complete mandatory online Safeguarding training and to renew this every 3 years.

Staff levels

Staffing rotas are organised based on young people’s support needs. Each young person support needs are mapped on a person centred plan to ensure that the right levels of support are provided to meet needs. Where possible, and where a young person’s need might be better met by a particular member of staff, based on their skills and experience, then rotas will be arranged so as to promote matching of staff to young people/groups on this basis.

Staffing levels are flexible and change to meet the needs and number of the children/young people staying at Holly House. This means that staff are always available at short notice to respond to changes in situations.

The Home Manager will look at each young persons’ care and support plans consider compatibility of young people staying together, support and care needs requirements. For example: Based on 6 young people staying at Holly House at one time; each young person’s needs are mapped to show the rhythm of the day from the start of day when people wake, have breakfast through the morning, lunchtime, afternoon, tea time, evening time and night time. The mapping shows the level of support a person needs at varying times of the day dependent on the task. This tool then provides a picture of staffing levels required to meet an individual’s support
needs; e.g. when a person may need 2:1 support with their personal care needs, then 1:1 support with eating their lunch but will then join other young people to take part in an activity.

Specialist staff

Any specialist skills required in order to provide care will either see staff trained to a standard that they can safely deliver this care, or would see a specific professional attend to provide elements of this care during any stay at Holly House: for example, specific medical care. If there is any specialist input required, more broadly to meet a child’s needs, this will be something identified within their ‘Multi Agency Care and Support Plan’ and will be organised and sourced by the Children With Disabilities Team.

Deployment of staff at service (for accommodation based services only)

Staff work on a rota basis and support is flexible to meet the individuals’ needs of people accessing Holly House. Additional staff are available in the event that care needs require it or that staff availability becomes an issue. Holly House will not operate with less staff than is required and respite will be postponed in the event that the number of children due to stay cannot be safely cared for.

Arrangements for delegated tasks

The Home manager has operational responsibility for Holly House. The Deputy manager and Senior Carer takes on this responsibility for each shift when the manager is off duty. There is an on call system for when the Home Manager is on annual leave to ensure management point of contact is always available.

Supervision arrangements

• Supervision Policy - All Staff have Supervision bi–monthly with the home manager or the deputy home manager. Staff are allocated to one of the managers as their main supervisor.
• Performance Appraisal Policy - All staff have annual Performance Appraisals and 6 month follow up review of their appraisals.
• Monthly staff meetings - All staff have the opportunity to attend monthly staff meetings, which take the form of an agenda, discussion and recorded minutes. This is chaired by the home manager and will be attend by the Responsible Individual at least 3 times per year.
• Management Supervision - The home manager is provided with direct 1 to 1 supervision by the Responsible Individual on a monthly basis. An annual performance appraisal will also be completed.

Staff training

• Staff training learning and development needs are identified via the supervision and performance review processes.
• All staff have gained an appropriate knowledge through a significant amount of training which enables them to provide support to each individual’s needs.
• All permanent staff have achieved an NVQ/QCF qualification in care, ranging from level 3 to level 5. The remainder of staff are currently working towards this achievement.
• All staff complete mandatory training and are updated regularly; All Wales Moving and Handling Passport, Infection Control, Child Protection, Fire Safety, Basic Food Hygiene, Record Keeping, Dementia, Safe Administration of Medicines, Complaints Training, and Emergency First Aid at Work, Deprivation of Liberty Standards.
• Staff access Pembrokeshire County Council online mandatory learning and development known as Pembrokeshire Online Development POD to complete all mandatory training. Where staff do not ordinarily have use of a laptop or other computer for their work, then they will be provided with a link with which to access their online POD account using their own machine at home. Alternatively they will be given access via an office computer and allowed time during their shift in which to complete the mandatory course.
  
  

Facilities and services

Holly House is a purpose built bungalow to accommodate the needs of young people with disabilities.

Number of single and shared rooms

4 single bedrooms all of which have a profiling bed/chest of drawers/TV point/lockable bedside table

Number of rooms with en suite facilities

2 bedrooms - 1 of which has a wet room/toilet and the other is a specialist shower room with overhead tracking and changing bed

Number of dining areas/Number of communal areas

Large open plan room accommodating a dining area and sitting room area with large sofas and TV, DVD and games consoles. This room leading out through doors into an enclosed garden space. There is a sensory room with sensory equipment and a resource room, which has desk area, to undertake art, and craft/play games/undertake homework.

Specialist bathing facilities

1 bathroom with overhead tracking and changing bed. Also a generic toilet in the bathroom, which enables young people to be as independent as possible by washing and drying the user with the use of a sensor/control pad

Specialist equipment

2 bedrooms with ceiling mounted tracking; tracking is an ‘h’ style track, which enables the Young person to access anywhere within that room.

• Sensory equipment
• Large kitchen with raise and fall work top/sink/hob and an eye level oven with foldaway door.
• 2 wall mounted cupboards drop down to worktop level; including a table and chairs for everyone to sit and prepare food.

Security arrangements in place and use of CCTV

• Key coded for entry/exit to ensure the safety of young people staying at the House.
• 3 Fire Exits are locked via magnet and can be open with a key or are automatically opened when fire alarms activated.
• All external doors and bedroom doors are fitted with a Tunstall door sensor which when activated informs staff on duty of which room/door has been opened.
• Holly House has CCTV but is not used when Young people staying at Holly House and is only operational when unit is closed.

Access to outside space and facilities at this service

• An enclosed garden space at the rear of the property, which is accessed via fire exit in lounge.
• Garden has a soft play area where young people can access garden toys and games.
• Play equipment - slide and a trampoline
  
  

Governance and quality monitoring arrangements

The Home operates as an in-house service provision of Pembrokeshire County Council – Social Care and Housing department, specifically falling within the responsibility of the Children’s Services department.

The home is compliant with Pembrokeshire County Councils policies, practices and procedures.

Regulation 73 Visits

The Responsible Individual (RI) will visit the home and complete paperwork to record their visit at least every three months. This task will not be delegated. During this visit the RI will monitor the performance of the service in relation to its statement of purpose and to inform the oversight and ‘quality of care’ review. The RI will during each visit where possible and practicable, carry out the following:

• Meet with members of staff in private and with their consent.
• Talk to young people and their representatives (if applicable) using the service in private and with their consent.
• View young people’s allocated rooms with their consent and in their company where appropriate and where agreed by that young person.
• Inspect all areas of the premises for general cleanliness, safety and comfort.
• Make recommendations to the manager (or deputy) as to the condition of the home and equipment within it, as well as the operating practices observed during the visit.
• On an annual basis, satisfy themselves that checks to electrical equipment, fire safety, gas safety and other checks pertaining to the building and its equipment and energy supplies have been carried out and indicate that the home remains safe to operate

The Governance and quality monitoring arrangements are as follows:

Supervision and Performance Review

• Manager’s supervision is completed by the RI on a monthly basis with a Performance Appraisal carried out annually.
• All Staff have formal Supervision bi – monthly, annual Performance Appraisals and 6 month review of appraisals.

Daily Handover

• Daily handover update at the end each shift change is carried out.

Line Management

• An on call system operates to ensure a manager can be contactable at all times.
• The Responsible Individual is available 24hrs per day and 365 days per year. 

Quality Assurance

• Questionnaires are given to individuals, professionals, staff, family and visitors to completed when they visit. Completed Questionnaires are collated 6 monthly and information feeds into the service development plan and business plans.
• Holly House is working towards developing a young person’s advocacy group independently facilitated at Holly House to enable people to contribute their views on Holly House and this will feed into the service development plan.

Data Protection

• All information maintained by the Home is in line with Pembrokeshire County Council’s Data Protection Policy.

Health and Safety

• The Home follows Health and Safety Pembrokeshire County Council Policies
• In addition, Procedures in line with HSE regulations.

CIW Inspections

• The Home is inspected by CIW and a copy of the most recent report is available online at Care Inspectorate Wales (opens in a new tab) 

Building, equipment and Fire Safety

• Staff on duty secure the building at night and follow procedures should an emergency occurs.
• Regular checks of all equipment in use and the environment are completed and documented. Risk assessments are completed, monitored and reviewed. All staff receive Health and Safety training and this is updated.
• The Home has an automatic Fire Alarm System, a Fire Defence Plan and Fire Risk Assessment for all Individuals and staff. All staff access fire safety training.
• The management will ensure as far as practical the health, safety and welfare of individuals, including compliance with relevant legislation.
• The building and its site is a no-smoking area.
• The Home has Employers Liability Insurance but individuals should ask advice regarding their personal property as necessary.

Accidents and Incidents

• Are reported to the PCC Safety Unit also the Head of Service and CIW as necessary

Compliments and Complaints

• Pembrokeshire County Council has a Compliments and Complaints Procedure
• Easy read versions are available to young people and their family/carers.
• Young People and their family/carers have contact details of Advocacy organisations that can provide independent support.

Advocacy

• Individuals are actively encouraged to participate and contribute to the running of the Home. Their views are important and will be taken into consideration by the Home Manager and staff. Families and representatives of Individuals who are not able to put their own views forward are encouraged to act as an advocate.
• Pembrokeshire County Council commission 3CIPA (opens in a new tab)  to provide independent Advocacy support to individuals.

Information Management

• The home will not provide information to relatives, spouses, friends or advocates without the consent of the individual resident and/or their parent/legal guardian holding parental responsibility. All enquiries for information, even if they are from close relatives, should be referred back to the individual or parent for the individual’s permission sought before disclosure. Information can be sourced through the Freedom of information Act officer at Pembrokeshire County Council.
• All staff are obliged to comply with the provisions set out within the General Data Protection Regulations (GDPR).

For further information please contact

Email: CCAT@pembrokeshire.gov.uk